Fitzgerald Health Education Associates (FHEA) is committed to the success of nurse practitioners; we publish practical information for practicing NPs and NP students, which includes NP interviews, NP certification Q&A;, avoiding malpractice, and news.
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Click to View Previous Issues... NP Firsts Leadership, Not Just Management A n Interview with Gale Adcock, MSN, RN, FNP-BC, FAANP GA LE AD COCK , MSN, RN, FNP-BC, FAANP, became the first nurse practi- tioner to be elected to the North Carolina General Assembly when she was elected on November 4, 2014, to North Carolina's House District 41. Before win- ning that seat in the state legislature, Ms. Adcock was the first NP elected to the Cary, North Caroli- n a, town council. Cary is a town of 150,000 known f or its superb quality of life and is on many "Best O f " lists for being a great place to live and work. She was reelected in 2011 for another 4-year term on the town council. Following her reelection, the other members of the council elected her Mayor Pro Tem, so she is in her third year as the first NP to be Mayor Pro Tem in Cary. Ms. Adcock is also the first NP to hold the posi- tion of Chief Health Officer at a major US corpora- t ion. Ms. Adcock has held that position for over 20 y ears at SAS Institute, Inc., the world's largest pri- vately held software company, where she over- sees a staff of 58 health care providers—including physicians, NPs, lab technicians, pharmacists, psychologists, and nutritionists—who serve the company's 5400 Cary, NC, headquarters employees and their families with com- prehensive primary care health services at the on-site health center. T wenty years ago when SAS decided to transition from an on-site urgent-care health center to one that provided free comprehensive primary care for all em- ployees and their families, it was a pioneering step. There were no models of how to run such a program. Ms. Adcock not only worked with an architect to help design the building renovations, she also helped create the primary care health center from the ground up, day-by-day, decision by decision. The center Inside NP Firsts ........................... 1 Certification Q&A............; 10 R eview Courses............... 13 Malpractice .................... 15 News Briefs ..................... 19 FHEA in the News ......... 24 2015 Live Courses Clinical Pharmacology ( 5 3/4-day course) NP Essentials Skills and Workshop (4- or 2-day courses) Pharmacology Update (2-day course) T he Art of Wound Repair (1-day course) NP Certification E xam Review Course Tracks Family, Adult-Gerontology, a nd Adult Primary Care Acute Care, Adult- Gerontology Acute Care P ediatric Primary Care P sychiatric & Mental Health Women's Health Click or see page 13 Look for bold orange text for clickable web links. F itzgerald Health Education Associates fhea.com 1 Fitzgerald Health Education Associates, Inc. 978•794•8366 Volume 14, Issue 11, November 2014 Gale Adcock, MSN, RN, FNP-BC, FAANP R epresentative-Elect, North Carolina House District 41 Chief Health Officer, SAS Institute, Inc. Cary, NC Certification Q&A; Q uestions About Certification, Interviewing M argaret A. Fitzgerald, DNP, FNP-BC, NP-C, FAANP, CSP, FAAN, DCC NPS AND STUDENTS often write to me for advice regarding certification as well as other issues they encounter as they launch their careers. Having helped more than 75,000 NPs achieve certification via my company, Fitzgerald Health Educa- tion Associates, Inc. I am always happy to answer such ques- tions. Below is a collection of a nswers to interesting questions about the NP certification exam and job interviews that were re- cently posed by your fellow NPs. C ERTIFICATION I attended your NP exam re- view and I am scheduled to take the American Nurses Cre- d entialing Center (ANCC) exam review. Does the ANCC exam include ques- t ion formats such as "select all that apply," ranking, and pictures? You should expect to see these types of questions if you take the ANCC exam. The Fitzgerald Health Education Associates review courses are suitable for all the certification exams, and they do incorporate the exam question styles that are f ound in the ANCC exams. When changes are made to guidelines, how long does it take for the new in- formation to show up on the certification exams? Changes to guidelines generally don't show up on the certification exam for at l east 6 months after they are published. Whenever new guidelines come out, t here is a transition period before they are integrated into any of the NP boards. Note that during such times of transition, questions usually will concentrate on the commonalities between two different sets of recommendations. I nside Certification Q&A; ............. 1 Psychiatric Consult ........... 5 Review Courses ................ 6 Prescribing News ............. 9 Update: Tobacco Use ..... 13 N ews Briefs ..................... 15 Fitzgerald Faculty News ..21 M emorial ........................ 23 2 015 Live Courses Clinical Pharmacology (5 3/4-day course) NP Essentials Skills and W orkshop (4- or 2-day courses) P harmacology Update (2-day course) T he Art of Wound Repair (1-day course) NP Certification Exam Review C ourse Tracks Family, Adult-Gerontology, and Adult Primary Care A cute Care, Adult- Gerontology Acute Care Pediatric Primary Care Psychiatric & Mental Health Women's Health Click o r see page 6 Look for bold orange text for clickable web links. F itzgerald Health Education Associates fhea.com Committed to the success of nurse practitioners 1 Fitzgerald Health Education Associates, Inc. 978•794•8366 Volume 14, Issue 12, December 2014 Residency & Fellowship Programs NP Residency and Fellowship Programs: Gaining Momentum THE FORMATION OF RESIDENCY AND FELLOWSHIP PROGRAMS for NPs in the United S tates is slowly but steadily gaining momentum. Although postgraduate pro- g rams remain relatively few, they are becoming more common, especially in community settings. Furthermore, these programs are somewhat controversial, 1 as there are calls from some entities in healthcare to make residency programs mandatory for new NPs. 2 P rogram Goals Residency and fellowship programs provide intensive training for both new and clinically experienced NPs. These full-time, structured, formal postgraduate pro- grams are designed to help new NPs make a smooth, successful transition from student to clinical practice, or to facilitate the transition of practicing NPs to a n ew clinical area. New NPs who want additional clinical education before enter- ing practice, and who are accepted to a program, have the opportunity to com- plete a 6- to 12-month residency prior to taking their first job. Fellowships are an avenue for practicing NPs who want to change disciplines or career paths, as well as for new NPs who want to follow a career path in a subspecialty area. Another primary goal of these programs is to increase the number of NPs practicing in specific clinical settings or specialty areas. In fact, the first NP residency program, started in 2007 by Margaret Flinter, PhD, APRN, C-FNP, at Community Health Centers (CHC), Inc. in Connecticut, was created not only to ease new NPs' transition to practice, but also to increase the number of family NPs in the high-intensity practice site of a federally qualified health center (FQHC). 3 Areas of Growth T he CHC family NP residency program began with four NP residents and cur- rently has 10 family NPs over the course of a 12-month residency. Health centers such as CHC are one area where NP residencies are expected to grow. CHC is a FQHC; as such, they receive federal funding to provide comprehensive primary care to underserved or vulnerable populations. The Affordable Care Act of 2010 I nside Residency & Fellowship Programs ........................... 1 Certification Q&A; ............. 5 Review Courses ............... 8 C ontraceptive Pearls ....... 9 News Briefs ..................... 11 Memorial ........................ 22 2 015 Live Courses Clinical Update (2-day course) NP Essentials Skills and Workshop (4- or 2-day courses) Pharmacology Update (2-day course) The Art of Wound Repair (1-day course) NP Certification Exam Review Course Tracks Family, Adult-Gerontology, and Adult Primary Care A cute Care, Adult- Gerontology Acute Care Pediatric Primary Care Psychiatric & Mental Health Women's Health Click or see page 8 L ook for b old orange text for clickable web links. Fitzgerald Health Education Associates fhea.com Committed to the success of nurse practitioners 1 Fitzgerald Health Education Associates, Inc. 978•794•8366 Volume 15, Issue 1, January 2015 December 2014 January 2015 November 2014 Clinical Update Evaluating and Treating Vitamin D Deficiency M argaret A. Fitzgerald, DNP, FNP-BC, NP-C, FAANP, CSP, FAAN, DCC VITAMIN D has long been rec- o gnized as essential for the ef- ficient absorption and utiliza- tion of dietary calcium as well a s for bone and muscle health. 1 Intestinal calcium absorption is s ignificantly enhanced by the presence of adequate vitamin D and is conversely reduced in deficiency of this important micronutrient. 1 During the past 1 5 years, research has highlighted multiple nonskeletal chronic diseases associ- ated with vitamin D deficiency, 2,3 including certain cancers, 4 cardiovascular diseases, 5,6 autoimmune diseases, 7,8 metabolic disorders, 9 and infectious dis- eases. 10 As an inhibitor of abnormal cellular growth, vitamin D is needed to help with cell differentiation and thereby minimize abnormal cell proliferation; t his abnormality is a key step in cancer development. 1,4 A stimulator of insulin secretion in response to increased blood glucose, vitamin D plays a role in the maintenance of normoglycemia by possibly minimizing the risk of developing type 2 diabetes mellitus. 9 Because vitamin D receptors are expressed by most cells of the immune system, vitamin D plays an important role as an immuno - m odu lator. 1 1 W hen vitamin D is available in physiologic amounts, this micronu- trient acts to decrease renin production, therefore contributing to blood pres- sure control. 12 S ources of Vitamin D A combination of dietary intake of foods rich in vitamin D in addition to regular periods of skin exposure to the sun should provide the body with an adequate Inside Clinical Update ................. 1 Malpractice .................... 10 Review Courses ............. 15 C ertification Q&A............; 16 Contraceptive Pearl ....... 19 News Briefs ..................... 22 2015 Live Courses N P Essentials Skills and Workshop (4- or 2-day courses) Pharmacology Update (2-day course) The Art of Wound Repair (1-day course) NP Certification Exam Review Course Tracks Family, Adult-Gerontology, a nd Adult Primary Care Acute Care, Adult- Gerontology Acute Care Pediatric Primary Care Psychiatric-Mental Health Women's Health Click or see page 15 Look for bold orange text f or clickable web links. Fitzgerald Health Education Associates fhea.com Committed to the success of nurse practitioners 1 F itzgerald Health Education Associates, Inc. 9 78 •7 94 •8 366 Volume 15, Issue 2, February 2015 February 2015 Clinical Update Measles: Making a Comeback Margaret A. Fitzgerald, DNP, FNP-BC, NP-C, FAANP, CSP, FAAN, DCC OUTBREAKS of vaccine-preventable diseases including measles (rubeola) are occurring with increasing frequency in the United States. In fact, the 644 measles cases reported in 27 states during 2014 is the highest number of cases reported since 2000, when the Centers for Disease Control and Preven- tion (CDC) declared measles eliminated in the United States. Elimination of a disease means that there has been no endemic disease transmission for at least 12 months. Although measles is no longer endemic in the United States, outbreaks still occur each year. The ongoing multi-state measles outbreak linked to two Disney theme parks in California, which began in December 2014, shows that measles remains a threat in the Unites States despite exten- sive vaccination efforts. 1 As the incidence of measles rises, all healthcare providers must ensure they can recognize the disease and know the appropri- ate steps to manage it. How Outbreaks Occur Outbreaks of measles occur in the United States when measles is imported by unvaccinated travelers (U.S. residents traveling abroad and foreign visitors) who acquire the infection while in other countries where the disease is en- demic or where an outbreak is occurring. Measles continues to circulate in many parts of the world, with an estimated 20 million cases occurring world- wide each year. 2 Once imported into this country, measles can spread readily in communities with low measles/mumps/rubella (MMR) vaccination rates. Measles is one of the most contagious viral diseases known, with secondary attack rates >90% in susceptible household and institutional contacts. Most people who get measles are unvaccinated or incompletely vaccinated. For ex- ample, of the 118 measles cases reported over a 19-week period in 2011, 89% occurred in unvaccinated persons. 3 In the recent California outbreak, 45% of cases were unvaccinated and another 43% had unknown or undocumented vaccination status. 1 Inside Clinical Update ................. 1 Review Courses............... 10 Certification Q&A............; 11 Update: Immunization ... 15 News Briefs ..................... 17 Fitzgerald Faculty in the News .............................. 23 2015 Live Courses Pharmacology Update (2-day course) The Art of Wound Repair (1-day course) NP Certification Exam Review Course Tracks Family, Adult-Gerontology, and Adult Primary Care Acute Care, Adult- Gerontology Acute Care Pediatric Primary Care Psychiatric-Mental Health Women's Health Click or see page 10 Look for bold orange text for clickable web links. Fitzgerald Health Education Associates, Inc. fhea.com Committed to the success of nurse practitioners 1 Fitzgerald Health Education Associates, Inc. 978•794•8366 Volume 15, Issue 3, March 2015 Continued on page 3 March 2015